Abstract: This invention pertains to systems and components useful for infusing medications such as insulin. Typically, the components are used to deliver insulin to a diabetic patient at a site of infusion over a period of time greater than 4 days. The system components typically comprise a cannula adapted for subcutaneous insertion into a diabetic patient. The system further comprises a fluid conduit adapted to deliver the insulin solution from a medication reservoir to the site of infusion and a depot in operable contact with the fluid conduit. The depot comprises selected materials including a site-loss mitigating agent (such as heparin) which inhibits inflammation at the site of infusion, and encapsulation of the cannula at the site of infusion. The site-loss mitigating agent is not premixed with the insulin, and instead is adapted to contact the insulin solution in the depot as the insulin solution flows from the medication reservoir to the site of infusion.

Abstract: A digitally timed complementary metal oxide semiconductor (CMOS) rectifier for wireless power transfer in an implanted medical device is provided. According to one aspect, a voltage rectification circuit for a medical device having an internal coil and internal circuitry includes a voltage rectifier comprising a complementary metal oxide semiconductor (CMOS) circuit having low-side first type MOS transistors and upper cross-coupled second type MOS transistors. The voltage rectifier may be configured to output a rectified received voltage, each low-side first type MOS transistor being configured with an first type MOS body diode, the low-side first type MOS transistors being enabled by a timing signal to provide conduction through the low-side first type MOS transistors while bypassing conduction through the first type MOS body diode during a time window having a duration determined by voltage level crossings of the received voltage.

Abstract: One embodiment is directed to a system for deploying a device to a distal location across a vessel, comprising an elongate introducer sheath tubing member comprising open-cell fibrous wall material defining a lumen therethrough, wherein in a collapsed configuration the sheath has a first cross-sectional outer diameter and a first lumen inner diameter, and in an expanded configuration, the sheath has a second cross-sectional outer diameter and a second lumen inner diameter; and a substantially non-porous expandable layer coupled to a proximal portion of sheath and configured to prevent fluids present in the lumen from crossing the fibrous wall material.

Abstract: Electrosurgical devices including a shaft, a handle and a distal end portion. The distal end portion is formed of an electrically conductive material and includes an electrically insulating material covering a substantial portion of the distal end portion and leaving an exposed portion which acts as an active electrode for delivery of electrical energy to tissue. A conduit in the shaft extending to an opening in the distal end portion facilitates aspiration of tissue and may provide suction simultaneous with delivery of electrical energy. Systems include an electrosurgical device, a source of electrical energy and may optionally include a source of suction and/or a source of fluid delivery or irrigation.

Abstract: A system, such as an IMD system, includes a tissue conductance communication (TCC) transmitter configured to generate a beacon signal by generating a carrier signal and modulating a first property of the carrier signal according to a first type of modulation. The TCC transmitter is configured to generate a data signal subsequent to the beacon signal by generating the carrier signal and modulating a second property of the carrier signal different than the first property according to a second type of modulation different than the first type of modulation.

Abstract: Ventricle-from-atrium (VfA) cardiac therapy may utilize a tissue-piercing electrode implanted in the left ventricular myocardium of the patient's heart from the right atrium through the right atrial endocardium and central fibrous body. The exemplary devices and methods may determine whether the tissue-piercing electrode is achieving effective left ventricular capture. Additionally, one or more pacing parameters, or paced settings, may be adjusted in view of the effective left ventricular capture determination.

Abstract: A catheter for measuring a fractional flow reserve includes a proximal shaft, a distal shaft coupled to a distal portion of the proximal shaft, and a pressure sensor coupled to the distal shaft. The proximal shaft includes a distal portion configured to extend through a stenosis in a vessel. The distal portion of the proximal shaft includes a radially expanded configuration having a first diameter and a radially collapsed configuration having a second diameter, wherein the first diameter is larger than the second diameter. The distal shaft includes a guidewire lumen configured to receive therein.

Abstract: This disclosure is related to devices, systems, and techniques for performing patient parameter measurements. In some examples, a medical device system includes an optical sensor configured to measure ambient light and a tissue oxygen saturation parameter and processing circuitry configured to determine that a current measurement of the tissue oxygen saturation parameter is prompted and control the optical sensor to perform an ambient light measurement associated with the current measurement of the tissue oxygen saturation parameter.

Abstract: VfA cardiac therapy uses an implantable medical device or system. The implantable medical device includes a tissue-piercing electrode implanted in the basal and/or septal region of the left ventricular myocardium of the patient's heart from the triangle of Koch region of the right atrium through the right atrial endocardium and central fibrous body. The device may include a right atrial electrode, a right atrial motion detector, or both. The device may be implanted completely within the patient's heart or may use one or more leads to implant electrodes in the patient's heart. The device may be used to provide cardiac therapy, including single or multiple chamber pacing, atrioventricular synchronous pacing, asynchronous pacing, triggered pacing, cardiac resynchronization pacing, or tachycardia-related therapy. A separate medical device may be used to provide some functionality for cardiac therapy, such as sensing, pacing, or shock therapy.

Abstract: An oxygenator apparatus for use in an extracorporeal circuit. The apparatus includes a housing and a membrane assembly disposed within the housing. The membrane assembly includes a first plurality of gas exchange elements disposed in a first zone and a second plurality of gas exchange elements disposed in a second zone. The second zone is arranged concentrically around the first zone. The first and second plurality of gas exchange elements are fluidly open along a body and fluidly separated along a distal end. The first zone is configured to be fluidly coupled to an oxygen source and the second zone is configured to be fluidly coupled to a negative pressure source. A blood flow path includes a generally radial flow through the first zone to add oxygen to the blood and the second zone to separate gaseous micro emboli from the blood through the plurality of gas exchange elements.

Abstract: Embodiments of the invention provide compositions useful in analyte sensors as well as methods for making and using such compositions and sensors. In typical embodiments of the invention, the sensor is a glucose sensor comprising an analyte modulating membrane formed from a polymer composition having carbonate and aromatic isocyanate chains, a composition observed to provide such membranes with improved material properties such as enhanced thermal and hydrolytic stability.

Abstract: Infusion devices and related medical devices, patient data management systems, and methods are provided for monitoring a physiological condition of a patient. An exemplary method of monitoring a physiological condition of a patient involves obtaining current measurement data for the physiological condition of the patient provided by a sensing arrangement, obtaining a user input indicative of one or more future events associated with the patient, and in response to the user input, determining a prediction of the physiological condition of the patient in the future based at least in part on the current measurement data and the one or more future events using one or more prediction models associated with the patient, and displaying a graphical representation of the prediction on a display device.

Abstract: A device and method are described for transmitting tissue conductance communication (TCC) signals. A device may be is configured to establish a transmission window by transmitting a TCC test signal at multiple time points over a transmission test period to a receiving device and detect at least one response to the transmitted TCC test signals performed by the receiving device. The IMD is configured to establish the transmission window based on the at least one detected response so that the transmission window is correlated to a time of relative increased transimpedance between a transmitting electrode vector and receiving electrode vector during the transmission test period.

Abstract: A method for automatically discriminating between a supraventricular tachycardia event and a ventricular tachycardia event is provided.

Abstract: Cardiac resynchronization therapy (CRT) delivered to a heart of a patient may be adjusted based on detection of a surrogate indication of the intrinsic atrioventricular conduction of the heart. In some examples, the surrogate indication is determined to be a sense event of the first depolarizing ventricle of the heart within a predetermined period of time following the delivery of a fusion pacing stimulus to the later depolarizing ventricle. In some examples, the CRT is switched from a fusion pacing configuration to a biventricular pacing configuration if the surrogate indication is not detected, and the CRT is maintained in a fusion pacing configuration if the surrogate indication is detected.

Abstract: Devices, systems, and techniques for analyzing video information to objectively identify patient behavior are disclosed. A system may analyze obtained video information of patient motion during a period of time to track one or more anatomical regions through a plurality of frames of the video information and calculate one or more movement parameters of the one or more anatomical regions. The system may also compare the one or more movement parameters to respective criteria for each of a plurality of predetermined patient behaviors and identify the patient behaviors that occurred during the period of time. In some examples, a device may control therapy delivery according to the identified patient behaviors and/or sensed parameters previously calibrated based on the identified patient behaviors.

Abstract: An intrathecal drug delivery system configured to monitor one or more physiological conditions of the patient to look for opportunities to time medicament delivery to coincide with patient activity inferring heightened cerebrospinal fluid oscillations, thereby improving dispersion of the medicament within the intrathecal space of the patient. The intrathecal drug delivery system includes an implantable medical pump, one or more physiological sensors, and an external programmer configured to program the implantable medical pump with a treatment protocol specifying at least one period of time during which a specified quantity of medicament is to be administered during which the implantable medical pump utilizes data from the one or more physiological sensors to time delivery of the medicament.

Abstract: A method of determining a pulsed field ablation waveform parameter for creating a desired lesion characteristic in cardiac tissue. The method of provides an electrosurgical generator configured to deliver electroporation pulses, the generator configured to: load predetermined waveform parameters (yi); load predetermined modeling data (xi); accept entry of a user inputted desired lesion characteristic (ui); and determine at least one corresponding pulsed field ablation waveform parameter based on (ui), (yi); and (xi).

Abstract: Medical devices provide metallic connector enclosures. The metallic connector enclosures may be constructed with relatively thin walls in comparison to polymer connector enclosures to aid in miniaturizing the medical device. The metallic connector enclosures may be constructed with interior surfaces that deviate less from an ideal inner surface shape in comparison to polymer connector enclosures to allow for better concentricity of electrical connectors. The metallic connector enclosures may include a panel that allows access to the cavity of the connector enclosure where set screw blocks, lead connectors, spacers, seals, and the like may be located. Furthermore, the lead connectors within the metallic connector enclosures may be separated from the metallic connector enclosure by being positioned within non-conductive seals that reside within features included in cavity walls of the connector enclosure.

Abstract: Aspects of this disclosure relate to a welding system that is configured to execute opposed, step, and parallel gap resistance spot welds (RSW) and associated methods. The system may be configured to switch bases to switch between an opposed weld configuration, a step weld configuration, and a parallel gap configuration. The system may include an accelerometer that is secured to the weld head adjacent one of the electrodes. The system may use the accelerometer to determine whether or not an RSW was defective. Acceleration data may indicate a defective weld when it includes acceleration data that is outside of a threshold range of acceptable acceleration data.